Kira Cochrane on how high-profile women's bodies became public property

Until last weekend, Fern Britton would have appeared among the least likely celebrities ever to find themselves in that lamentable, terrifying position: plastered all over the front page of the News of the World. The warm 50-year-old mother of four who presents daytime TV fixture This Morning (and latterly the throwback quiz show Mr & Mrs) is widely liked and respected; the most fuss she has ever caused is by corpsing on air with her co-presenter Phillip Schofield during a discussion about underpant gussets. Given the tabloid predilection for splashes involving sex, or drugs - ideally both - she seemed unlikely to come on to their radar.

But last Sunday, there she was. Under a headline reading "Fern Britton's fat band con", the NoW explained, in its usual understated terms, that the "telly favourite" had "confessed last night that her dramatic weight loss is down to a GASTRIC BAND - and NOT exercise and sensible eating". The reporter went on to recount a conversation he'd had with Britton's agent, John Rush - in which Rush initially stated that "this story is preposterous and utterly untrue. If you publish it, it is a libellous statement". The report then quickly turned to that ecstatic moment, eight hours later, when Britton had "publicly ADMITTED she'd had a band fitted". Given the emphatic use of capitals, you'd have thought Britton had admitted to snorting an illicit substance off a politician's chest.

The fallout arrived thick and fast. In the two years since Britton has had her gastric band fitted - a period in which she has lost five stone - she has attributed her weight loss to healthy eating and exercise, something that might literally be true when you've had the size of your stomach reduced considerably, but also involves an obvious, significant omission. The NoW suggested that she had lied through her teeth, bolstering its case with an unfortunate comment from her husband, TV chef Phil Vickery, that "Fern has lost a lot of weight through cycling, walking the dog and not eating too much, simple as that". The paper also floated the idea that she had been cashing in on her weight-loss success, mentioning that she had released an exercise video, Lynne Robinson's Everyday Pilates with Fern Britton, which had been a bestseller. Kerching! The fact that said video was released in 2003, some years before Britton actually had her operation, apparently didn't merit discussion.

On the online comment boards, a vitriolic reaction ensued. "I was in awe of your new shape," wrote "Rachel", on the NoW website, "but really you are a cheat ... you just fell off your pedestal. I'm disappointed." On the same site "Susie" wrote that, "I don't care how someone loses weight, but at least be honest about the way you do it. Fern is a role model to thousands in this country. Why oh why didn't she come out with this at the start?" On digitalspy.co.uk, a commenter wrote, with feeling, that "this is the most sickening act of deception I think I have come across. She is hardly the big woman's role model now. I hope she loses her TV contract". In fact, the general comment was so bilious that Britton clearly felt under pressure to make a statement. Yesterday, on This Morning, she came on air, her manner a mixture of breeziness and barely suppressed anger, and said that she had had the operation "for me, because I wanted to. I didn't feel that I had the need to ring around and let everyone know - in fact, only five people knew, including my husband". She added, perhaps a touch disingenuously, "I didn't expect that there would be such enormous interest in body image and perception."

As the scandal continues - Britton's comments simply prompting more vitriol yesterday, particularly from Amanda Platell in the Daily Mail - it raises a few major questions. The first is why Britton opted for the operation in the first place - and why she lied about it. The second is why it has caused such a massive fuss.

Britton isn't alone in deciding that surgical intervention is the best way to address her weight. Over the past year, the number of people having gastric bypass surgery in the UK has risen by 41%, to 3,459 operations in all. Judith Eastwood, for example, who now works as an adviser on weight-loss surgery for a private company, The Hospital Group, had a gastric band fitted three-and-a-half years ago. Eastwood's story is a familiar one: one diet followed by another, significant weight loss, a moment to bask in success and hope - and then despair as it piled back on. A 44-year-old mother of one, Eastwood's greatest regret is that her son "missed out because of my weight problems", and though she had to remortgage her house to pay the £7,450 cost of the operation (and says that she'll "be paying that back for the next 11 years"), she believes that it was definitely worth it. With a body mass index (BMI) of 40 before the operation, she had been looking at a seriously reduced lifespan - experts say that a 40-year-old woman with a BMI that high is likely to lose 8-10 years of their life. After having the band fitted - a procedure that she says "was very painful ... the muscles in your stomach are stretched, so you're sore, stiff and bruised" - she quickly lost six stone. Assuming that the surgery is successful, patients can expect to lose between 50% and 60% of their excess weight.

Given her extensive television career, viewers have had a ringside seat as Britton's weight has risen over the years. When she became the BBC's youngest ever national news presenter, with a spot on Westward Television in Plymouth, she was very slim. Over the years, like many, her figure has changed, and she has talked openly about the depression and health issues that she has experienced. After the birth of her daughter, Gracie, for instance, she had an extended period of postnatal depression, and has said that she was "halfway to falling apart" and contemplated suicide. "I remember sitting in the bath thinking, 'How many pills have I got in the bottle?'"

Britton battled through with the help of her second husband, Vickery. Then, when pregnant with her youngest child, Winnie, she was beset by fibroids. Vickery has said that "practically every week she would end up in casualty because of the fibroids. I would have to pick her up off the floor at 4am and not be able to move her for 45 minutes because she was in such pain".

Having come through all this, having established herself in a major role on daytime television, earning a reported £700,000 a year, surrounded by a clearly supportive and happy family, it wasn't surprising that Britton looked so at ease, so vital, when she was pictured in a swimsuit on a beach in 2005. The photographs attracted huge attention - the subtext of which seemed to be "How could anyone that fat appear in public in a swimsuit?" Responding to the criticism, Britton proclaimed, "I am what you'd call a voluptuous size 16 and proud of it," and said, "I know medical experts are telling me I'm cutting my life short and with a young family that's pretty terrifying. But do I want my kids to see me moping around depressed or frustrated? Wouldn't it be better to be remembered as a jolly old soul?"

A chorus of women writers yelled: "No." Platell, again, wrote that "alas, Fern is no more a size 16 than my native Australia is the proud holder of the Ashes ... there comes a point where an occasional self-indulgence becomes greed and where a few excess pounds become a life-threatening problem ... Certainly, Fern is not alone in her self-delusion, so why pick on her, you may ask? Well, Fern's case is special because she is a role model for millions of women who sit down with her every morning for coffee via their TV sets ... What woman could be happy having not seen their toes for a decade?"

It's impossible to know whether it was the comments of those medical experts, or the widespread bitchery, that led Britton to have the operation - most probably a combination of the two. And it's equally impossible to know exactly why she didn't declare it. She has suggested that she didn't want people to emulate her - and certainly, there would be reason for such qualms. One in 2,000 people die as a result of gastric band surgery, and for between 10% and 50%, the operation is unsuccessful - a serious problem if you've gambled your house on it. John Baxter, president of the British Obesity Surgery Society, and an NHS employee, says that he's used to patients saying that they want to have their surgery privately "when it suits them, and they know that no one else is around. They'll say that they want to hide it from their employer, relatives, friends, because there is an enormous feeling of guilt. I think it's because of society's prejudice - this idea that obese people just can't control their eating". For some patients, he thinks, admitting that they've had surgery, that that's how they've lost the weight, is tantamount to an admission of failure.

Certainly a lot of people seem to believe that Britton has failed. In fact, what her situation has underlined, very decisively, is just how much women's bodies remain public property, to be picked over, prodded and criticised, ad infinitum. Britton was condemned in the toughest terms when she was overweight, attracting a huge amount of opprobrium for saying that she was happy and fat. This was considered a scandal, because it might encourage people to be equally satisfied with their obesity, and, by association, their ill health. Now that she has lost weight, she is being criticised for "betraying" fat women, and for the way that she went about it - the mud being thrown is that she must be too lazy, too greedy, too feckless, too out of control, to slim down the "proper" way, even though it is well established that very few people are able to lose large amounts of weight through dieting, and keep it off long-term. She is being called a liar for having kept her surgery to herself - and yet, had she come out with it of her own accord, there seems a very good chance that she would have been pilloried for setting a surgical example, for potentially setting other people on a dangerous, and often unsuccessful course.

Britton's situation isn't unique - the arguments played out over the bodies of women in the public eye are intense and unrelenting. It is also true that, whatever their weight, women just can't win. You only have to look at the average weekly gossip magazine, for instance, to see women's bodies coming under serious scrutiny. On the cover of Heat this week, for instance, we learn that Nicola Roberts and Cheryl Cole of Girls Aloud are in the midst of a "skinny crisis" - but there seems little doubt that if they put on so much as five pounds apiece they would find themselves in similar magazines, being pointed at, laughed at, accused of being chubby, dimpled, or in the midst of a "fat crisis", considered vulgar, unpleasant, an unbridled disgrace to women as a whole, too massive and meaty by far. Interestingly, this assault on women's bodies has only risen as we have become more successful at work, more visible in the world, and seems to represent a clear attempt to keep us in our place: neurotic, unhappy and unfulfilled. I have a suspicion that it works, too.

Perhaps the best thing about Britton is her obvious warmth, her sympathetic way with guests, and, compared with many people, an apparent lack of guile and neurosis that seems to come from having seen the worst of life, and coming through it to see the very best, too. The sniping over her body will no doubt continue - as it does regarding every woman in the public eye; if she loses "too much" weight, she will be criticised more, just as she will if her weight ever increases again. All this comment is a massive distraction and often intensely nasty. Rather than getting dragged down by it, I hope that Britton will respond, mentally, if not actually literally, with a pointed two-word phrase. Fuck' em.

The uncomfortable truths about weight-loss surgery

A gastric band operation is a form of weight-loss surgery where a surgeon puts an adjustable silicone loop (like an elastic band) around the upper part of the stomach to make a smaller pouch, leaving a tiny gap leading to the rest of the stomach. This makes you feel full after eating only a very small amount. The operation - done with keyhole surgery - is reversible, and involves a general anaesthetic and usually an overnight stay. Studies show that, on average, people lose between 50% and 65% of their excess weight within two years with a gastric band.

However, gastric bands are not appropriate for every obese person. They work best on so-called "volume eaters" - people who became fat simply by eating very large meals. Those with more complex psychological problems around food are usually offered a more invasive type of surgery, a gastric bypass ("stomach stapling"), where surgeons basically replumb your insides, dividing the stomach so that it is much smaller, then bypassing the rest of the stomach and much of the small intestine to create "malabsorption". This means that not only are you forced to eat less, your body absorbs less of what you do eat. It is vital to eat very healthy foods with a gastric bypass, or your body becomes starved of nutrients. People tend to lose 66%-75% of their excess weight within two years with this more drastic op.

Fern Britton's gastric band is, then, the most straightforward choice. But there are downsides. Gastric bands do not work for everybody. Without lifestyle changes, weight loss can plateau, so Britton's assertion that the past two years have involved a lot of healthy eating, dog walking and cycling, is totally credible.

It is also possible to sabotage your gastric band by grazing constantly (you still manage to take in too many calories, so you do not lose weight). This is why counselling and support are vital, though counselling is not routinely offered on the NHS.

There are scarier risks, too. Any surgery carries a risk of infection, bleeding, blood clots or heart attack and the dangers rise if you are obese. According to the British Obesity Surgery Patient Association (Bospa), about one in 2,000 people die while having a gastric band inserted and studies suggest that one in 10 people will need a further operation at some point, as gastric bands can slip, erode into the stomach, leak or become infected. Overall, about 1 in 100 people having any kind of obesity surgery will die as a result of the procedure.

Then again, recent studies show that those who have the surgery are less likely to die in the next 10 years than those who stay fat. One study showed that they are 92% less likely to die from diabetes, 60% less likely to die from cancer, and 56% less likely to develop heart disease.

Though there are no government statistics showing exactly how many British people have gastric bands fitted on the NHS, it is clear that numbers are rising steeply. Bospa now receives around 4,000 queries a month from people desperate to have weight-loss surgery.

So, what are your chances of getting a gastric band fitted on the NHS? Government guidelines recently stated that anyone over the age of 12 with a body mass index of over 40 (or over 35 if they also suffer from a serious, obesity-related illness such as diabetes or heart disease) should qualify for obesity surgery on the NHS. Despairing NHS staff have pointed out that this means up to a million people in the UK, including hundreds of children, now qualify for the surgery.

In other words, anyone seeking a gastric band on the NHS faces a postcode lottery and huge waiting lists. Many will therefore go private. While prices vary, a gastric band usually costs around £7,000 to £8,000

(a private gastric bypass can cost between £10,000 to £12,000).

Ultimately, while surgery can help some people to lose weight, experts agree that it will never be the answer to the obesity crisis. As a spokesperson from the Department of Health says: "The focus on tackling obesity is still on prevention."

· This article was amended on Friday June 6 2008. We originally said that a silicon loop is placed around the upper part of the stomach during a gastric band operation. We meant silicone (the compound), not silicon (the chemical element). This has been corrected.